~SIEMENS SIEMENS BUILDING TECHNOLOGIES, INC. FIRE SAFETY DIVISION

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1 ~SIEMENS SIEMENS BUILING TECHNOLOGIES, INC. FIRE SAFETY IVISION INSPECTION AN TESTING FORM ATE: TIME: 6:3 am SERVICE ORGANIZATION PROPERTY NAME (USER) Name: -=Si=em=en..:.::sc..::B:..::u:.:.:.:ild::..:;in"'"g. T.:...:ec=hn..:..:o:.:..:log=ies::a... Name: Kctcs Bowling Green, Transark Address: 27 Stanley Gault Pkwy Address: 221 Commonwealth Blvd. Louisville Kentucky 4223 Bowling Green, Kentucky 4214 Reresentative: _:...:M~arn~ ~n~h~in~~~e Owner Contact: _M~ed~e=a~Sc=o~tt"' License No.: _F"""A... R.;...;-1;;..;4=5.;;;..8 Telehone: (27) Telehone: (52) MONITORING ENTITY TYPE TRANSMISSION McCulloh Multilex!ti igital (Silent Knight 5148) Reverse Priority RF Shunt Parallel Phone None APPROVING AGENCY Contact: Siemens Monitoring Oerator Contact: Telehone: (Sn) Telehone: Monitoring Account Ref. No.: _11_2 9_3_3_5 SERVICE Weekly Monthly Quarterly Semiannually!ti Annually other (Secify) other (Secify) Control Unit Manufacturer: Edwards Model Number: _EST aaaa..a_o"'"'u=ic=ks=ta~ rt' Orcuit Styles: Class B Location: Mechanical Room Number of Circuits:...;a.. s Software Rev.: Last ate System Had Any Service Performed: Last ate that Any Software or Configuration Was Revised: QUANTITY ALARM-INITIATING EVICES AN CIRCUIT INFORMATION CIRCUIT STYLE Photo etector uct Photo etector Manual Pull Station Waterflow Alarm Alarm Verification Feature is isabled Enabled ~X~- (NFPA Insection and Testing, 1 of 6)

Louisville Kentucky 4223 Bowling Green, Kentucky 4214 Reresentative: _:...:M~arn~ ~n~h~in~~~e Owner Contact: _M~ed~e=a~Sc=o~tt"'----------- License No.: _F"""A... R.;...;-1;;..;4=5.;;;.

2 'SIEMENS SIEMENS BUILING TECHNOLOGIES, INC. FIRE SAFETY IVISION QUANTITY ALARM N11FICA11N APPUANCES AN CIRCUIT INFORMA11N CIRCUIT Sm.e 29 Style Y Hom/Strobes ----=12:;._ Style Y Strobes Number of alarm notification aliance circuits: _4..;... Are circuits monitored for integrity? Yes SUPERVISORY SIGNAL-INITIATING EVICES AN CIRCUIT INFORMA11N QUANTITY 2 CIRCUIT STYLE Style 4 Tamer Switch SIGNAUNG LINE CIRCUITS Quantity and style of signaling line circuits connected to system (see NFPA 72, Table 6.6.1): Quantity O Style(s) SYSTEM POWER SUPPUES (a) Primary (Main): Nominal Voltage -=12... Ams...:.; 2= vercurrent Protection: Tye Breaker Ams...:.; 2= Location (of Primary Suly Panel Board): isconnecting Means Location: -'-' M.;:;.; ech = an;.;.;i.;;;;; ca;;.:.j.;.; R.;:;.; oo:;.;.m;.;. (b) Secondary (Standby): Storage Battery: Am-Hour Rating _ 4.:..: :::. s calculated caacity to oerate system, in Hours: Engine-driven generator dedicated to fire alarm system: Location of fuel storage: TYPE BATTERY O ry Cell Nickel-cadmium ~ Sealed Lead-Acid Lead-Acid Other (Secify): (c) Emergency or Standby system used as a backu to rimary ower suly, instead of using a secondary ower suly: Emergency system described in NFPA 7, Article 7. Legally required standby described In NFPA 7, Article 71. Otional standby system described in NFPA 7, Article 72, which also meets the erformance requirements of Article 7 or 71. (NFPA Insection and Testing, 2 of 6)

Yes SUPERVISORY SIGNAL-INITIATING EVICES AN CIRCUIT INFORMA11N QUANTITY 2 CIRCUIT STYLE Style 4 Tamer Switch SIGNAUNG LINE CIRCUITS Quantity and style of signaling line circuits connected to system

3 SIEMENS SIEMENS BUILING TECHNOLOGIES, INC. FIRE SAFETY IVISION NOTIFICATIONS ARE MAE Monitoring Entity Building Occuants Building Management Other (Secify) AHJ Notified of Any Imairments PRIOR To ANY TESTING YES No WHO Oerator 6:3 am All 6:3 am TIME TYPE Control Unit Interface Equiment Lams/LES Fuses Primary Power Suly Trouble Signals isconnect Switches Ground-Fault Monitoring SYSTEM TESTS AN INSPECTIONS FuNcnONAL SECONARY POWER TYPE Battery Condition Load Voltage ischarge Test Charger Test Secific Gravity Transient Suressors Remote Annunciators funcnonal Customer relaces batteries Main LobbY: NOTIFICATION APPUANCES Audible Visual Seakers Voice Oarity FuNcnONAL INITIATING AN SUPERVISORY EVICE TESTS A N INSPECTIONS *N OTE: ONLY EVICES THAT HAVE BEEN TESTE ARE INCLUE HERE. YlsUAL FUNcnONAL FACTORY MEASURE LOCATION & 5/N MCETYPE CHECK TEST SETllNG SETllNG Room 115 Storage Photo etector Room 116 Storage Photo etector Room 114 Storage Photo etector x Room 11 Storage Photo etector x /R Room 112 Photo etector x Egui12ment Room bl. Ors /5 Room 112 Photo etector x North OlS Mechanical Room Photo etector Room 112 Storage Photo etector High Ba~ Room Photo etector Room 112 Photo etector bl. Ors /5 Room 112 Photo etector x South OlR Room 117 Storage Photo etector x PASS FAIL (NFPA Insection and Testing, 3 of 6)

am TIME TYPE Control Unit Interface Equiment Lams/LES Fuses Primary Power Suly Trouble Signals isconnect Switches Ground-Fault Monitoring SYSTEM TESTS AN INSPECTIONS FuNcnONAL SECONARY POWER TYPE

4 SIEMENS SIEMENS BUILING TECHNOLOGIES, INC, FIRE SAFETY IVISION FUNCTIONAL FACTORY MEASURE location & 5/N EVICE TYPE CHECK TEST 5ETIING SETTING PASS FAIL Ol R Room 114 Storage Photo etector x uct etector # 1 Loft uct Photo etector x uct etector # 2 Loft uct Photo etector x uct etector # 3 Loft uct Photo etector x uct etector #4 Loft uct Photo etector x uct etector # 5 Loft uct Photo etector x uct etector #6 Loft uct Photo etector x uct etector #7 Loft uct Photo etector x uct etector #8 Loft uct Photo etector x uct etector #9 Loft uct Photo etector x uct etector #1 Loft uct Photo etector x uct etector # 11 Loft uct Photo etector x uct etector # 12 Loft uct Photo etector x uct etector # 13 Loft uct Photo etector x Above FACP Photo etector x OLR Room 115 Storage Photo etector x Ol R Room 117A Sto~ Photo etector x Ol R Room 116 Storage Photo etector x Ol R Room 112 Storage Photo etector x Mechanical Room Photo etector x Bt Room 117 Manual Pull Station x!!l'. Room 13 Manual Pull Station x Hl51h BaJ'.: Room Manual Pull Station x Main Lobb!'. Manual Pull Station x Waterflow Waterflow Alarm x TamE!,!r #1 Transfer Switch x Tamoer #2 Transfer Switch x fbi: Room 114 Manual Pull Station x!!l'. Room 18 Manual Pull Station x High Bay Room 11 Manual Pull Station x South Room 118 Exit Manual Pull Station x Welding Room 112 Exit Manual Pull Station x High Bay Room 11 Manual Pull Station x North _SlE Exit ~ Room 13 Manual Pull Station x..j!cjj. Exit!:t: Room 117 Manual Pull Station x Ol R Room 114 Photo etector x OLR Room 117 Photo etector x Ol R Room 112 South Photo etector x 112Sto~ Photo etector x Outside Mechanical Photo etector x Room Comments: All Initiating evices Worked Proerly. * = Manually set the 'Pass' state (NFPA Insection and Testing, 4 of 6)

uct etector #6 Loft uct Photo etector x uct etector #7 Loft uct Photo etector x uct etector #8 Loft uct Photo etector x uct etector #9 Loft uct Photo etector x uct etector #1 Loft uct Photo etector x

5 SIEMENS SIEMENS BUILING TECHNOLOGIES, INC. FIRE SAFETY IVISION AUIO FAILURES EVICE LIST LOCATION &S/N MCETVPE PASS FAIL Comments: All Hom/Strobes Worked [Proerly (NFPA Insection and Testing, 5 of 6)

&S/N MCETVPE PASS FAIL Comments: All Hom/Strobes

6 . SiEMENS SIEMENS BUILING TECHNOLOGIES, INC. FIRE SAFETY IVISION EMERGENCY COMMUNICATION EQUIPMENT Phone Set Phone Jacks Off-Hook Indicator Amlifier(s) Tone Generator(s) Call-in Signal System Performance FUNCTIONAL INTERFACE EQUIPMENT (Secify) AHU Shutdown (Secify) NAC Extender Panel (Secify) EVICE OPERATION SIMULATE OPERATION SPECIAL HAZAR SYSTEMS (Secify) (Secify) (Secify) Secial Procedures:..J.r.w.!i Commen~: _.u:1t.1..1:1,. ~~-~ ~~~-- SUPERVISING STATION MONITORING YES No TIME CoMMENTS Alarm Signal ~ Alarm Restoration Suervisory Signal Suervisory Restoration ~ Trouble Signal Trouble Restoral NOTIFICATIONS THAT TESTING IS COMPLETE YES No WHO TIME Monitoring Agency Oerator 1:3 am Building Occuan~ All 1:3 am Building Management Medea Scott 1:3 am Other (Secify) The following did not oerate correctly: The System Tested Good With No eficiencies. System restored to normal oeration: ate:...:,~ al...,-l..,,6, Time: 1:3m THIS TESTING WAS PERFORME IN ACCORANCE WITH APPLICABLE NFPA STANARS. Name of Insector: Martin Hinkle ate: Time: 1:3m Signature: Name of Owner or Reresentative:...1.M;..i.:,ed-eall!...&Sc~ot.i.tt1r :3..,'""'""m... ate: Time: Signature: (NFPA Insection and Testing, 6 of 6)

AHU Shutdown (Secify) NAC Extender Panel (Secify) EVICE OPERATION SIMULATE OPERATION SPECIAL HAZAR SYSTEMS (Secify) -------- (Secify) -------- (Secify) --------- Secial Procedures:..J.r.w.!i.-------------------------------- Commen~: _.

INSPECTION AND TESTING FORM

INSPECTION AND TESTING FORM SERVICE ORGANIZATION PROPERTY NAME (USER) DATE: 08-04-15 TIME: 8:00 Name: Siemens Industries Inc. Name: Kcvtcs Madisonville Tech, School Bldg. Address: 2700 Stanley Gault Pkwy